To provide a concise review of the literature on desmopressin use for antiplatelet reversal in patients with intracranial hemorrhage.
Source data were obtained from a PubMed literature review.
Studies addressing desmopressin for antiplatelet reversal.
Relevant studies were reviewed and included through consensus of the authors. The following aspects of each study were identified, abstracted, and analyzed study population, study design, methods, results, and relevant implications for practice.
A growing body of evidence continues to provide mixed results for the use of desmopressin in patients presenting with antiplatelet-associated intracranial hemorrhage. The potential benefit outweighs the possible risks associated with a one-time dose. In addition to desmopressin, platelets should only be considered in patients undergoing a neurosurgical procedure until further and superior evidence is available. Guidelines recommend a weight-based approach for desmopressin dosing at 0.4 mcg/kg over 30 min.
The available evidence supports desmopressin as potentially beneficial with minimal risk for use in patients with antiplatelet-associated intracranial hemorrhage.
The available evidence supports desmopressin as potentially beneficial with minimal risk for use in patients with antiplatelet-associated intracranial hemorrhage.Millions of Americans are injured each year, with 75% suffering orthopedic injuries. Those with orthopedic injury often experience postinjury symptoms, such as anxiety, that negatively influence long-term outcomes. The purpose of this systematic review was to evaluate (1) the prevalence of anxiety symptoms chronologically in relation to time of orthopedic injury, (2) the associations of anxiety symptoms with other symptoms in individuals with orthopedic injury, and (3) the associations between anxiety symptoms and functional performance and mental health outcomes in individuals with orthopedic injury.
The databases CINAHL, Ovid MEDLINE, Ovid PsycInfo, Ovid Embase, ProQuest, and ClinicalTrials.gov were searched on June 25, 2020. Studies were selected for review if (1) participants were 16 years or older, (2) the prevalence of anxiety symptoms was listed, (3) anxiety symptoms were assessed using a validated instrument, (4) the study was published in English, and (5) more than 50% of the participants suffered orthopedic injury to the appendicular skeleton or pelvic ring.
Anxiety symptoms were present in 11.5%-55.9% of individuals up to 10 years after orthopedic injury and often co-occurred with those of depression, pain, and posttraumatic stress disorder to negatively influence functional performance and mental health outcomes.
Anxiety symptoms post-orthopedic injury are highly prevalent and persistent. Anxiety symptoms are associated with other distressing symptoms and influence long-term outcomes. These findings highlight the need to screen for and treat anxiety symptoms following orthopedic injury and may help in designing future self-management interventions.
Anxiety symptoms post-orthopedic injury are highly prevalent and persistent. Anxiety symptoms are associated with other distressing symptoms and influence long-term outcomes. These findings highlight the need to screen for and treat anxiety symptoms following orthopedic injury and may help in designing future self-management interventions.Trauma centers are charged with identifying injury prevention priorities in the community. https://www.selleckchem.com/products/ml198.html Hospitals frequently use system and regional injury data based on frequency of injury mechanisms to establish injury prevention priorities.
This study was conducted to provide insight into how the Injury Prevention Priority Score (IPPS) can be utilized to prioritize injury prevention activities with considerations of both frequency and severity of injury.
This descriptive study utilizes a retrospective review of 6,824 patients 15 years and older at one Level I trauma center between July 1, 2014, and June 30, 2019. A previously described and validated IPPS was calculated for injury mechanisms to compare the overall trauma burden for each cause. The IPPS is presented as a T-score with a mean of 50 and a standard deviation of 10.
In this sample, most injuries (57.1%) occur to those 65 years or older, and the most common injuries are from a fall (66.5%) or were from a motor vehicle occupant (13.3%). The fall group had an average severity of injury, but the frequency was five times higher than the next highest group. The pedestrian and firearm groups had the highest severity, and their IPPSs were the second and third highest.
Injury priorities should not be based on frequency of injury alone. Use of the IPPS provides additional objective data regarding injury prevention priorities in the community. The IPPS has most commonly been used to evaluate pediatric injury prevention needs but effectively evaluates injury prevention needs throughout the lifespan.
Injury priorities should not be based on frequency of injury alone. Use of the IPPS provides additional objective data regarding injury prevention priorities in the community. The IPPS has most commonly been used to evaluate pediatric injury prevention needs but effectively evaluates injury prevention needs throughout the lifespan.On-scene ambulatory status following a motor vehicle crash (MVC) serves as an informal marker of physiologic stability. The influence of ambulatory status after an MVC on trauma team activation and injury severity is infrequently studied, yet may alter the clinician's index of suspicion for injury. The purpose of this study is to describe the injury burden of ambulatory on-scene patients following an MVC.
This is a prospective descriptive study of MVC patients arriving by emergency medical services (EMS), with trauma team activation, to a Midwestern Level I trauma center from July through December 2018. The EMS records were reviewed for wording that indicated the patient's ambulatory status following an MVC. Those denoted as "ambulatory on-scene" were included in this study. Of this subset, Injury Severity Score (ISS), hospital admission status, safety mechanisms utilized, crash scene description, and demographics were collected.
A total of 648 MVC patients with trauma activations were reviewed, of which 308 met criteria for study inclusion.